Objective:To evaluate the application of analyzing neutrophil cell surface marker CD64 in diagnosis of premature infants infection.Methods:109 infants inpatient in neonatal department(including NICU)were enrolled in the study.CD64 was measured by FCM,which was compared with C-reactive protein(CRP)and IL-6.Results:There was a statistically significant difference in quantitation of CD64 on neutrophil cells(P

Objective To evaluate the effect of losecplatin combined with compound matrine in the intraperitoneal perfusion treatment of ovarian cancer with malignant ascites and its influence on the levle of serum tumor necrosis factor alpha(TNF-) of ovarian cancer marker.Methods 60 ovarian cancer patients with malignant ascites were divided into three groups:losecplatin combined with compound matrine perfusion group(combination group),single losecplatin perfusion group(losecplatin group) and single compound matrine perfusion group(compound matrine group),20 cases in each group.Before treatment,all the three groups were drained intraperitoneal fluid,then given the above-mentioned group of intraperitoneal perfusion therapy.The effects,side effects and serum TNF- levels of the three groups were compared.Results The patients of the three groups were successfully completed treatment,the effective rate of the combination group was 95%,which of the losecplatin group was 60%,which of the compound matrine group was 55%.The effective rate of the combination group was significantly higher than that of the single drug group(χ2=7.025,P<0.05),and the adverse reaction of the combination group was not significantly increased(χ2=1.026,P>0.05).The serum TNF- levels of the three groups after the perfusion treatment were significantly decreased(t=15.40,13.82,8.90,all P<0.05),TNF- level of the combination group was significantly lower,the difference was statistically significant(F=9.719,P<0.05).Conclusion Losecplatin combined with compound matrine in the intraperitoneal perfusion is a more effective method for the treatment of ovarian cancer with malignant ascites,which is worthy of promotion.

Background Human LECs can express telomerase activity,which participates in the formation of cataract.It is reported that estrogen can increase the expression of telomerase activity in human endometrial cancer and breast cancer cells and play an important role in promoting proliferation and anti-apoptosis,but whether estrogen exerts its role on human LECs is still unclear.Objective This study aimed to investigate whether β-estradiol (β-E2) can increase the telomerase activity of human LECs and the influence of β-E2 on proliferation and apoptosis of human LECs.Method Human LECs line was cultured and passaged in vitro,and 1×10-6 mol/L β-E2 was added in the medium for 0,6,12,24 and 48 hours,and reverse transcription PCR was used to determine the optimal time of the expression of human telomerase reverse transcriptase (hTERT) mRNA in the cells.Cultured cells were divided into five groups.The cells in the blank contol group were cultured in the routin medium.Ethanol of 0.1％ was added in the solvent control group,and 1 × 10-8,1 × 10-7 or 1 × 10-6 mol/L β-E2 was added in the medium in different contents of β-E2 groups,respectively.The relative expression level of hTERT mRNA in different groups was detected by reverse transcription PCR.Telomere repeat amplification protocol (TRAP)-ELISA was employed to determine the telomerase activity.The proliferative value of the cells was assayed by cell counting kit-8,and the apoptosis rate of the cells was examined by Hoechst33258 staining.Results The optimal time of β-E2 to rise the expression of hTERT mRNA (absorbance) was at 24 hours under the 1×10-6 mol/L.The relative expression levels of hTERT mRNA in the cells were 0.477±0.015,0.712±0.013 and 0.914±0.031 in the 1 ×10-8,1 ×10-7 and 1 ×10-6 mol/L β-E2 group,which were signifincatly higher than 0.428±0.010 in the blank control group and 0.426±0.010 in the solvent control group (all at P＜0.05).The telomerase activity values (absorbance) were 0.711 ±0.015,0.941±0.010 and 1.249±0.047 in the 1×10-8,1×10-7and 1×10-6 mol/L β-E2 group,which were higher than 0.535±0.013 in the blank control group and 0.543 ±0.013 in the solvent control group (all at P =0.000).The proliferantive values of the cells (absorbance) were significantly raised in the 1 × 10-8 mol/L β-E2 group compared with l × 10-7 and 1 × 10-6 mol/L β-E2 group (both at P =0.000),and no significnant difference was found in the proliferetive values between the blank control group and the solvent control group (P =0.718,0.856).The apoptosis rates of the cells in the 1 × 10-8,1 × 10-7 and 1 × 10-6 mol/L β-E2 group were lower than those in the the blank control group and the solvent control group (all at P=0.000),and there was no significant difference between the blank control group and the solvent control group (P =0.777).No obvious correlation was found between the HLECs preliferative values and hTERT mRNA expression levels or telomerase activity values (r=-0.299,P=0.278;r=-0.157,P=0.576).However,significantly negative correlations were seen between apoptosis rates and hTERT mRNA expression levels or telomerase activity values (r =-0.975,P=0.000;r=-0.981,P=0.000).Conclusions β-E2can increase the activity of telomerase in human LECs,and high dose of β-E2can inhibit apoptosis,but it dose not promote proliferation.

Objective To investigate the clinical and histopathologic features of patients with primary gastrointestinal malignant lymphoma ( PGIML). Methods The clinical and histopathologic data of 22 patients with PGIML were reviewed and analyzed retrospectively. All cases were confirmed with histological specimen obtained from endoscopic biopsies or surgery. Results Abdominal pain was the most common presenting symptom, seen in 15 of 22 patients (68.2% ). The incidence of PGIML was highest in stomach, seen in 12 of 22 patients (54. 5% ). Modularity of the mucosal surface was the most common endoscopic finding, seen in 15 of 21 patients (71. 4% ). The positive rate of endoscopic biopsy for the diagnosis of PGIML was 52. 6% (10/19 biopsy cases). All cases were non-Hodgkins lymphomas ( NHL). Twenty cases were muco-sa associated lymphoid tissue (MALT) lymphoma, and 13 of 20 cases were extra-nodal marginal zone B-cell lymphoma of MALT. Conclusions Abdominal pain is the most common symptom and the stomach was the most common location in PGIML. Extra nodal marginal zone B-cell lymphoma of MALT is the main histopathologic feature. The prognosis of PGIML is related to the surgical procedure and the post operative chemotherapy.

To adapt to the system reformation of medical laboratory science from five academic years to four academic years and to meet the new professional technology-oriented requirements, the medical laboratory science institute of Guangdong Medical College has carried out a comprehensive reform of curriculum system. This paper has analyzed the current problems in the school medical ex-amination and explored the curriculum system reform from three respects such as adjusting curriculum by restructuring and integrating programs, implementing modular teaching to build its characteristics and strengthening practice teaching.And it has also explored the full assessment mode by optimizing the traditional one-stop assessment.

Objective To explore the prevention and treatment strategies for the infectious renal artery rupture after renal transplantation of organ donation after citizens death (DCD).Methods The clinical data of 5 donors and their corresponding recipients with infectious renal artery rupture after renal transplantation were retrospectively analyzed with review of the literature.Results The corresponding donors of 5 recipients had the potential risk factors for donor-transmitted infection (DTI):1 case of traumatic rupture of small intestine,2 cases of digestive tract injury when resecting the donor kidney from DCD donors,1 case of severe pneumonia and 1 case of multiple renal contusion.The pathogenic microorganisms were found in the culture of kidney preservation solution,including klebsiella pneumoniae in 1 case,candida albicans in i case,enterococcus.No pathogens were detected in 1 case,and kidney preservation solution taken from the external hospital was not cultured in 1 case.The pathological examination on the resected renal grafts revealed the necrosis of the arteries and the infiltration of lymphocytes.The culture of bacteria and fungi in the removed vessel walls of renal grafts and the iliac tissues showed there were 2 cases positive for candida albicans (case 2 and case 4),1 case for cryptococcus neoformans (case 1),1 case for klebsiella pneumonia (case 5).No pathogenic bacteria were detected in 1 case,but the possibility of fungal infection was more likely.In case 1,the second kidney transplantation was performed 10 months later after artery re-transplantation,and the kidney function was normal during the follow-up period.In case 4,the second kidney transplantation was performed 2 months later after transplant nephrectomy due to the refractory rejection,the transplanted kidney experienced a rapid loss of graft function,and the blood dialysis was given continuously.The remaining 3 patients survived so far,waiting for re-transplantation.No case of bleeding occurred again in the 5 recipients.Conclusion Renal graft artery rupture is one of most severe complications after renal transplantation.It is the key for preventing infectious renal artery rupture to screen strictly infection of donors and recipients,and to use sensitive and wide coverage antimicrobial to the donors before the removal of donor kidney and during the perioperative period after renal transplantation.Early detection and operation as soon as possible is the only treatment to save the lives of the recipients.

Objective To observe the clinical effect of intensity modulated radiation therapy (IMRT) combined with apapatinib mesylate in the treatment of elderly patients with locally advanced cardia adenocarcinoma and its effect on vascular endothelial growth factor receptor (VEGFR). Methods Forty-six elderly patients with locally advanced cardia cancer who were unwilling to accept surgery or couldn't get complete removal of cancers in Xuzhou Hospital Affiliated to Jiangsu University between January 2015 and April 2016 were collected. All the patients were randomly divided into the control group (23 cases) and the observation group (23 cases) according to the random number table method. The control group received radiotherapy alone. In the observation group, oral apatinib (500 mg/d) was taken in the first day of radiotherapy after breakfast until the disease progress or death occurred. Results The total effective rate was 92 % (19/23) in the observation group and 60 % (10/23) in the control group. There was a significant difference between the two groups(χ2=5.86,P <0.05). After treatment, the average level of VEGFR in both groups was decreased[(76.3±4.9)vs.(55.0±2.3)pg/ml],and there was a significant difference between the two groups (t = 3.93, P < 0.05). The common adverse reactions were blood adverse reactions and gastrointestinal reactions. The incidence rate of gastrointestinal reaction was both 83 %, and the blood adverse reaction was 100 %, and there was no significant difference between the two groups (both P > 0.05). Hypertension, proteinuria and rash response in the observation group were increased compared with the control group,but noⅣ grade of adverse reactions occurred. The median progression-free survival time was 10 months in the observation group and 8 months in the control group respectively (P = 0.01). Conclusion IMRT combined with apatinib in the treatment of elderly patients with locally advanced gastric cardia has a favorable efficacy and tolerance.

Objective To observe the clinical efficacy of large fraction intensity modulated radiation therapy combined with apatinib in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome. Methods A retrospective analysis was made on 46 elderly patients with non-small cell lung cancer and superior vena cava syndrome who were admitted to Xuzhou Cancer Hospital Affiliated to Jiangsu University from February 2015 to December 2017. The patients were divided into observation group and control group with 23 cases in each group. The control group received radiation therapy only. Apatinib was enrolled in the observation group on the first day synchronously. The remission time of symptoms, short-term efficacy, occurrence of adverse reactions and 1-year overall survival rate were observed and compared between the two groups. Results The complete remission rate was 78.3％ (18/23) in the observation group and 43.3％ (10/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.60, P < 0.05). The effective response rate was 86.9％ (21/23) in the observation group and 65.2％ (15/23) in the control group, and the difference between the two groups was statistically significant (χ 2 = 4.294, P < 0.05). The main adverse reactions in the two groups were radioactive esophagitis, radiation pneumonitis and leukopenia, and most of them were grade Ⅰ-Ⅱ, there was no significant difference between the two groups (all P > 0.05). The 1-year overall survival rate was 56％ in the observation group and 40％ in the control group, and the difference between the two groups was statistically significant (P = 0.009). Conclusion Large fraction intensity modulated radiation therapy combined with apatinib is effective in the treatment of elderly patients with non-small cell lung cancer and superior vena cava syndrome, and theadverse reactions are well tolerated.

Objective:To explore the efficacy and adverse reactions of image-guided hypofractionated intensity-modulated radiotherapy (Ig-HypoRT) conbined with contralateral esophageal protection in treatment of patients with unresectable stage Ⅲ non-small cell lung cancer (NSCLC).Methods:The clinical data of 45 patients with unresectable stage Ⅲ NSCLC who were admitted to Xuzhou Cancer Hospital from January 2016 to January 2019 were retrospectively analyzed. Patients received induction chemotherapy with a platinum-based dual-drug combination regimen, followed by Ig-HypoRT with a total dose of tumor of 60-63 Gy/12- 18 times at 3.5-5.0 Gy/time. Contralateral esophagus was delineated as an organ at risk during radiotherapy, limiting V 45 Gy≤1.8 cc and V 55 Gy ≤0.4 cc. Patients' efficacy, survival and the occurrence of adverse reactions were observed. Results:Among 45 patients, there were 9 cases of complete remission, 31 cases of partial remission, 4 cases of stable disease and 1 case of disease progression, and the effective rate was 88.8% (40/45). The median follow-up time was 34 months, 45 patients had a median overall survival (OS) time of 25.0 months (95% CI 21.7-28.8 months), with 1-, 2-, and 3-year OS rates of 78.9%, 56.8% and 47.7%, respectively; the median progression-free survival (PFS) time was 18.5 months (95% CI 15.0-22.0 months), with 1-, 2- and 3-year PFS rates of 59.8%, 32.6% and 18.6%, respectively. The 3-year local recurrence rate was 9% (4/45). The incidence of grade 1-2 radioactive esophagitis was 80% (36/45); the incidence of grade 1-2 chest pain was 20% (9/45). The incidence of grade 3-4 adverse reactions were 13% (6/45), including 7% (3/45) of grade 3 pulmonary atelectasis, 4% (2/45) of grade 3 radioactive pneumonia, and 2% (1/45) of grade 4 hemoptysis. Conclusions:Ig-HypoRT combined with contralateral esophageal protection for unresectable stage Ⅲ NSCLC can improve survival rate and reduce esophageal adverse reactions of patients.

Objective:To observe the effects of cervical region Ⅱ and oral target area optimization on therapeutic efficacy, salivary gland function and oral mucosal response during intensity modulated radiation therapy (IMRT) for oropharyngeal cancer.Methods:A total of 50 patients with oropharyngeal squamous cell carcinoma in Xuzhou Cancer Hospital from January 2012 to May 2017 were collected. According to the random number table, they were divided into normal radiotherapy group (the control group), oral and cervical target area optimization group (the observation group), 25 cases in each group. Both groups were treated with IMRT and platinum-chemotherapy. The control group received bilateral cervical region Ⅱ-Ⅳ lymphatic drainage area irradiation (the positive side of the cervical lymph node included Ⅰ B region), and bilateral cervical region Ⅱ was given a tumor dose of 60 Gy (positive lymph nodes were given intensified irradiation); the observation group was optimized for the target area, and the contralateral cervical region Ⅱ B (the side with no positive lymph node) was given a tumor dose of 50 Gy; the observation group's oral structure was delineated as an organ at risk and the average radiation dose (D mean) was limited to <32 Gy. The differences in radiation dose of parotid gland, acute oral mucosal reaction and long-term xerostomia (6 months after the end of radiotherapy), objective remission rate (ORR), local recurrence rate (LRR), 3-year overall survival (OS) were compared between the two groups. Results:In the control group, the contralateral parotid gland D mean was (29±4) Gy, the proportion of irradiation volume exposed to 34 Gy (V 34) was (48±5)%; in the observation group, contralateral parotid gland D mean was (23±3) Gy, V 34 was (41±5)%, and there are statistically significant differences between the two groups ( t values were 6.14, 4.98, all P < 0.05). In the control group, oral D mean was (35±6) Gy, the proportion of volume exposed to 30 Gy (V 30) was (36±5)%; in the observation group oral D mean was (29±4) Gy, V 30 was (28±4)%, and there were statistically significant differences between the two groups ( t values were 4.11, 5.98, all P < 0.05). The incidence of ≥ grade Ⅱ acute oral mucosal adverse reaction and the duration time of oral mucosal ≥ 2 weeks was 64% (16/25) and 76% (19/25), respectively in the control group, 36% (9/25) and 40% (10/25), respectively in the observation group; and the differences were statistically significant ( χ2 values were 3.92, 6.65; P values were 0.048, 0.009). The incidence of ≥ grade Ⅱ long-term xerostomia reaction was 72% (18/25) and 44% (11/25), respectively in the control group and the observation group, and the difference between the two groups was statistically significant ( χ2 = 4.02, P = 0.044). The ORR, LRR, and 3-year OS rates were 80%, 28%, 48% in the control group, and 76%, 24%, 44% in the observation group. There was no statistically significant difference in the OS between the two groups ( χ2 = 0.04, P = 0.849). Conclusions:Optimization of the target area of the oral and cervical region Ⅱ during IMRT for oropharyngeal carcinoma can improve the function of salivary glands, thereby reducing dry mouth and oral mucosal reactions, improving the quality of life of patients; and it does not affect the efficacy of tumor treatment.